The Bilingual VISIBL- MS Tool Captures Early Clinical Symptoms at the Onset of Multiple Sclerosis (MS) in a Diverse Urban Population
Sai Viswanathan1, Michael Vazquez1, Carlos Gutierrez2, Karen Nelson2, Jaime Imitola2
1School of Medicine, University of Connecticut, 2UConn Health MS center
Objective:
To examine the efficacy of the VISIBL-MS tool in capturing initial CIS symptoms in MS
Background:
Lack of awareness regarding Multiple Sclerosis (MS) in diverse, rural, and low-resource communities contributes to significant diagnostic and treatment delays, resulting in worse patient outcomes. To address this gap, we developed VISIBL-MS, a portable, multifunctional bilingual card that presents the clinically isolated syndrome (CIS) symptoms in plain language to raise awareness among patients, their families, and non-neurology healthcare workers.
Design/Methods:
We performed a retrospective study with patients diagnosed with MS (n=100) at UConn Health from May 1st, 2018 to May 31st, 2024. Data on demographics, social deprivation index (SDI), and symptoms were collected. The primary outcome was the percentage of patients who presented with symptoms outlined in VISIBL. Secondary outcomes included time to diagnosis, time to DMT. Statistical analysis was performed using Jamovi version 2.3
Results:
There was an association between race and both SDI score and education level. African American (AA) and Hispanic patients had higher SDI scores and education disadvantage scores compared with White patients. All patients (100%) presented with at least one VISIBL category, most common were limb symptoms(75.5%), visual symptoms (46.8%), and changes in balance or gait (36.2%). The mean time to diagnosis was: 187 days (Hispanic), 159 days (White), and 143 days in AA. The mean time to DMT initiation was: 82.5 days for White, 193 days for AA, and 78.8 days for Hispanic patients. There were no significant differences in time to diagnosis or time to DMT initiation with ancestry. Notably, patients with optic neuritis had a shorter median time to diagnosis compared with those without (17 vs. 112.5 days).
Conclusions:
The VISIBL-MS tool captures early manifestations of MS. Notably, patients with painful visual symptoms had the shortest time to diagnosis. Limitations of the study include retrospective design and single-center sample.
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